Productive General Practice in the NHS

Rationale / Objectives

The Productive General Practice Programme was designed in 2010 to help general practice continue to deliver high quality care whilst meeting increasing levels of demand and diverse expectations. It helped practices to put the patient, clinician and practice team at the centre of improvement to create a timely, appropriate and dependable response to patient needs. Implemention efforts included staff engagement to improve their work processes, making it possible to release time to invest in improving patient outcomes and staff wellbeing. The central theme of The Productive Series is that great care processes do not just evolve, they need to be designed. 

Project/Program Description & Major Achievements

The Programme was rigorously tested in co-production with seven test sites before being rolled out for implementation on a wider scale. Packages of materials and support were made available for purchase to general practices across the NHS. Various toolkits and workshops designed to implement various process improvements were part of the programme and were made freely available for download. Thorpe-le-Soken Surgery implemented the programme and achieved a 50% reduction in waiting times for their patients as well as a 42% increase in staff morale. Concord Medical Centre in Bristol used tools available in the program to look at the number of attendances for significant patient groups and found mental health to be a priority area. Using funds freed up from a GP's retirement, the team implemented a mental health specialist nurse position and achieved an 85% reduction in hospital referrals for mental health. This also resulted in an extra 1000 hours of GP time that was freed up each year to focus on other primary care issues. Maryport Health Centre used tools to examine and improve their processes resulting in a reduction in the number of calls GPs have to make by 80% and released time for an extra two patients to be seen each day. A new process was introduced at Highbridge Medical Centre where all scripts for each destination are scanned and converted to searchable electronic files resulting in a £12,500 saving in the first 12 months.

Lessons Learned

Practices identified that they actually have an abundance of data already available to them that can point to areas where there are opportunities for improvement. However, some of this data is often not accessed or presented in a format that provides useful information.

Further Description

In May 2010 the NHS Institute commenced a rapid innovation cycle to explore the potential to apply the ‘Productive’ approach within general practice. A core aim of this initial work was to scope the opportunities for improvement throughout general practice and the potential to help practices respond to the changing and growing financial and clinical demands placed upon them by the NHS. Productive General Practice was designed to be implemented by existing teams and did not assume any prior knowledge of improvement tools and techniques or project management expertise. The programme was designed achieve savings and benefits in a number of ways: 

  • Avoiding cost – for example through less use of locum support 
  • Generating more income – for example through being able increase list size or introduce new services without increasing resources 
  • Reducing cost – for example through lower absenteeism, reduction in inventory, lower energy costs, reduction and/or more precise use of capacity

A number of packages and levels of support were offered to general practices at a fee (starting at £2105).  All packages included:

  • a set printed of modules and downloadable PDF versions
  • a range of over 70 different resources to choose from - including improvement tools, templates and pro-formas – to support implementation of the Productive General Practice
  • 14 instructional videos covering each module, 27 case studies
  • 4 short e-learning courses to support learning on the key methodologies used in the programme.
  • on-site support

Major Achievements

Metric Result Detail 
patient wait times 50% reduction At Thorpe-le-Soken Surgery
staff morale 42% increase At Thorpe-le-Soken Surgery
hospital referrals for mental health 85% reduction At Concord Medical Centre 
number of calls GPs need to make 80% reduction At Maryport Health Centre
cost savings in 12 month period £12,500 At Highbridge Medical Centre